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91_HB1118
LRB9101909KScs
1 AN ACT to amend the Medical Patients Rights Act by
2 changing Section 3.
3 Be it enacted by the People of the State of Illinois,
4 represented in the General Assembly:
5 Section 5. The Medical Patient Rights Act is amended by
6 changing Section 3 as follows:
7 (410 ILCS 50/3) (from Ch. 111 1/2, par. 5403)
8 Sec. 3. The following rights are hereby established:
9 (a) The right of each patient to care consistent with
10 sound nursing and medical practices, to be informed of the
11 name of the physician responsible for coordinating his or her
12 care, to receive information concerning his or her condition
13 and proposed treatment, to refuse any treatment to the extent
14 permitted by law, and to privacy and confidentiality of
15 records except as otherwise provided by law.
16 (b) The right of each patient, regardless of source of
17 payment, to examine and receive a reasonable explanation of
18 his total bill for services rendered by his physician or
19 health care provider, including the itemized charges for
20 specific services received. Each physician or health care
21 provider shall be responsible only for a reasonable
22 explanation of those specific services provided by such
23 physician or health care provider.
24 (i) No insurance company, health services
25 corporation, or their agents or subcontractors shall
26 deny payment for medically necessary inpatient
27 admissions and related services solely because the
28 patient or health care provider did not notify the
29 insurance company, health services corporation, or their
30 agents or subcontractors of the admission, provided that
31 the patient or health care provider has attempted to
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1 contact the insurance company, health services
2 corporation, or their agents or subcontractors.
3 (ii) No insurance company, health services
4 corporation, or their agents or subcontractors shall
5 enter into an agreement with a physician or other health
6 care provider containing any incentive plan that
7 includes specific payment made directly, in any form, to
8 a physician or other health care provider as an
9 inducement to deny, reduce, limit, or delay specific,
10 medically necessary and appropriate services provided
11 with respect to a specific patient or groups of patients
12 with similar medical conditions. Nothing in this Section
13 shall be construed to prohibit contracts that contain
14 incentive plans that involve general payments such as
15 capitation payments or shared-risk arrangements, that
16 are not tied to specific medical decisions involving
17 specific patients or groups of patients with similar
18 medical conditions. The payments rendered or to be
19 rendered to a physician or other health care provider
20 under these arrangements shall be deemed confidential
21 information.
22 (c) In the event an insurance company or health services
23 corporation cancels or refuses to renew an individual policy
24 or plan, the insured patient shall be entitled to timely,
25 prior notice of the termination of such policy or plan.
26 An insurance company or health services corporation that
27 requires any insured patient or applicant for new or
28 continued insurance or coverage to be tested for infection
29 with human immunodeficiency virus (HIV) or any other
30 identified causative agent of acquired immunodeficiency
31 syndrome (AIDS) shall (1) give the patient or applicant prior
32 written notice of such requirement, (2) proceed with such
33 testing only upon the written authorization of the applicant
34 or patient, and (3) keep the results of such testing
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1 confidential. Notice of an adverse underwriting or coverage
2 decision may be given to any appropriately interested party,
3 but the insurer may only disclose the test result itself to a
4 physician designated by the applicant or patient, and any
5 such disclosure shall be in a manner that assures
6 confidentiality.
7 The Department of Insurance shall enforce the provisions
8 of this subsection.
9 (d) The right of each patient to privacy and
10 confidentiality in health care. Each physician, health care
11 provider, health services corporation and insurance company
12 shall refrain from disclosing the nature or details of
13 services provided to patients, except that such information
14 may be disclosed to the patient, the party making treatment
15 decisions if the patient is incapable of making decisions
16 regarding the health services provided, those parties
17 directly involved with providing treatment to the patient or
18 processing the payment for that treatment, those parties
19 responsible for peer review, utilization review and quality
20 assurance, and those parties required to be notified under
21 the Abused and Neglected Child Reporting Act, the Illinois
22 Sexually Transmissible Disease Control Act or where otherwise
23 authorized or required by law. This right may be waived in
24 writing by the patient or the patient's guardian, but a
25 physician or other health care provider may not condition the
26 provision of services on the patient's or guardian's
27 agreement to sign such a waiver.
28 (Source: P.A. 86-895; 86-902; 86-1028; 87-334.)